The Coalition of Limited English Speaking Elderly (CLESE) was founded by twelve leaders of ethnic organizations in 1989 as a result of a comprehensive ethnic elderly needs assessment conducted in the city of Chicago that examined the needs of immigrant, refugee and migrant older adults. The purpose of the study was to find out why ethnic elderly were under-represented in the utilization of traditional social services. The needs assessment conducted 1,500 personal interviews in ten languages with older adults from twelve ethnic groups. The results showed that ethnic elderly needed services, were eligible for services, but were not receiving them due to barriers of language and culture.
To guide the needs assessment process, the Chicago Department on Aging and Disability (the area agency on aging for the city of Chicago) formed an advisory committee whose tasks were to identify interviewers, assist in training them, translate the assessment tool and most important, to identify at least 150 older adults in each group who would be able to engage in the one and a half hour interview. In the process of meeting together, the advisory committee members realized that they had much more in common than what might be assumed given that they were from very different countries. All were bi-lingual, bi-cultural and all had experienced difficulties themselves in adjusting to life in a new country. One ethnic agency executive director said that she was afraid to give public testimony on the needs of the elders in her community because she spoke with an accent and worried that people would hear her accent and not her words. Everyone else at the table understood. They came to see that by speaking with one voice, they would be heard. The results of the ethnic elderly needs assessment spurred them into action and the members of the advisory committee incorporated as the Coalition of Limited English Speaking Elderly with the mission to improve the lives of limited-English-speaking elderly through leadership, education and advocacy.
From the beginning, CLESE membership reflected the ethno-linguistic diversity of the Chicago metropolitan area. No one group or sub-group has ever dominated; members now represent countries from all parts of the globe. As the fortunes of not-for-profits wax and wane, and as new groups of refugees and immigrants arrive, some organizations leave the coalition and new ones join. In the second year of its existence, CLESE had 26 organizational members; presently, it has 51. Critical to the success of the coalition is that all members are welcome at the table. While there may be occasional competition between different organizations within the same ethnic community, CLESE members have always appreciated and worked well with representatives from other ethnic groups. The 20-member CLESE Board of Directors is comprised solely of executive or program directors of agencies serving ethno-linguistic communities. The number of Asian Board members very closely corresponds to the percentage of Asian CLESE member organizations as do other Board members to the percentage of their ethnic groups to the total.
The ethnic elderly needs assessment was widely distributed among the aging network leadership. In response to the documented gap in services to limited-English speaking elderly, the Illinois Department on Aging changed its rules for the home-based and community services program funded by a Medicaid waiver and Illinois General Revenue funds. The first two contracts targeted to specific populations were awarded to two communities, one Chinese and one Korean, in1991. The new homemakers were trained at an established provider organization that served both mainstream and Spanish-speaking clients, with appropriate interpreters supplied by the new providers. CLESE provided technical assistance to new provider organizations, including writing a homecare training manual and helping new providers understand homecare program regulations. Presently, 10,000 limited-English speaking elderly (one-sixth of the state’s total clients) receive adult day and or homemaker services in Illinois from twenty-one CLESE member organizations.
Other major programs over the years have either addressed a demonstrated need in the limited-English speaking populations or have been an exploration of a particular need. CLESE has received funding for health screening fairs and several health education programs, translation of health and safety information, citizenship preparation, English instruction for older adults, elder abuse and neglect identification and intervention, services specifically for refugees, Alzheimer’s disease awareness, combating depression, and a number of capacity-building projects. CLESE has received grants and contracts from city, state and federal government, from area agencies on aging and from various foundations. Very limited fund-raising is conducted in order not to compete with CLESE member organizations.
In order to ensure continued program relevance and attention to critical issues, CLESE checks updated Census data, discusses issues of concern at Board meetings, researches issues in specific ethnic populations, conducts surveys of member organizations and has recurring conversations with major funders, officials and other aging, immigrant, and refugee network leaders. For example, ten years ago, CLESE convened focus groups in 15 ethnic communities with older adults; a total of 550 elders discussed their needs and voted on priorities for changing public policies. CLESE then convened a Multicultural Senior Conference that enabled 220 older adults to talk with elected officials and authorities.
CLESE has advocated on a variety of issues, all addressing the disparity of services and benefits or seeking to inform mainstream officials about particular needs of immigrant, refugee and migrant elderly. For example, CLESE honored family caregivers at an event attended by 200 ethnic older adults. CLESE has given public testimony, sent press releases, been interviewed for various publications and on radio, and has coordinated public events. CLESE has sought recognition for successful individual limited-English speaking elderly and for ethnic service providers.
CLESE speaks on behalf of the 51 ethno-linguistic member organizations to the general public and to specific officials, decision-makers and funders. CLESE represents ethnic communities on committees, advisory councils and other vehicles that foster an improved understanding of and access to limited English-speaking elderly. CLESE presents at a minimum of five state and national conferences a year, in addition to speaking at many meetings, seminars, and workshops, always with the intent to educate the attendees.
CLESE programs follow a similar pattern: CLESE researches a problem, need or issue and decides whether to pursue funding; the Board is involved in making the decision. If yes, CLESE writes and submits the proposal, developing the program plan in consultation with Board members or other leaders. CLESE chooses the participating organizations based upon the extent of the specific problem within the community, the relative size of the elderly population speaking a language, by the willingness of an agency to participate, and or by geographic considerations. CLESE coordinates orientation and training, often with experts in the particular program, designs the data collection forms for compliance and ease of use, modifies the project as needed, collects the data, and reimburses each participating agency upon submission of documentation for work successfully performed. CLESE writes the reports and publicizes the findings. Some programs may have as few as three participating CLESE members and some as many as twenty-five.
Many evidenced-based programs, proven successful with mainstream elderly, cannot be replicated in ethnic communities without significant modification. One example: in the Alzheimer’s disease project, CLESE learned that Alzheimer’s disease could not be translated, there was a tremendous amount of stigma in having a “mental illness,” ethnic families did not designate one primary “caregiver;” there were many obstacles of language and culture in obtaining a comprehensive medical assessment to rule out other causes of dementia. CLESE is engaged with several universities and individual researchers in exploring how to adjust evidence-based practices without losing fidelity to the original program.
Coalition of Limited English Speaking Elderly (CLESE)
53 West Jackson, Suite 1301
Chicago, IL 60604
312-461-0812 / 312-461-1466 (fax)